Is early Weight Bearing Allowed in Surgically Treated Talar Neck Fractures?

Non-or partial weight bearing is frequently the standard treatment after peri-articular lower extremity fractures. Displaced talar neck fractures are severe injuries compromising vascularity of the corpus and consequently are at risk for non-union and avascular necrosis, the main reason to restrict weight bearing for up to three months according to most literature.

We report a case of a 31-year old male with a high impact car accident. His pelvic ring and Hawkins II talar fracture were treated by open reduction and internal fixation. Rehabilitation was based on permissive weight bearing following wound healing. His fractures healed uneventfully and he was able to run freely, without any discomfort within 8 weeks. Radiological evaluation of the talus showed complete bone healing without signs of avascular necrosis. At one year follow-up, the patient is free of the symptoms.

We might consider changing the restricted or non-weight bearing protocol in surgically treated talar neck fractures at our centre and allow early weight bearing, based on body awareness and the creation of a safe environment during the rehabilitation phase.